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Radiology, Vol 204, 119-122, Copyright © 1997 by Radiological Society of North America

ARTICLES

US-guided left-sided biliary drainage: nine-year experience

N Hayashi, T Sakai, M Kitagawa, T Kimoto, R Inagaki and Y Ishii
Department of Radiology, Fukui Medical School, Yoshida-gun, Japan.

PURPOSE: The feasibility and safety of left-sided biliary drainage with ultrasound (US) guidance were studied prospectively. MATERIALS AND METHODS: From July 1987 to July 1996, 208 consecutive patients underwent US-guided biliary drainage; all were evaluated for left-sided drainage. Drainage procedure was begun with puncture of the hepatic duct branch of the lateral segment of the left lobe when the branch was well visualized with US; otherwise, a right-sided approach was used. When the hepatic duct branch diameter was greater than 3 mm, puncture was performed with an 18-gauge needle; smaller branches were punctured with 21-gauge needles. RESULTS: In 147 (71%) patients, the left hepatic duct branch was well visualized with US, and the branch diameter was greater than 3 mm. In these patients, left-sided drainage with use of an 18-gauge needle was successful. In 26 (12%) patients, the left hepatic duct branch diameter was less than 3 mm, and drainage was initiated with a 21-gauge needle. In six (23%) of these 26 patients, left-sided drainage was unsuccessful, but five of these patients underwent successful US-guided drainage from the right hepatic duct branch. Two patients died of septic shock within 72 hours of completed drainage. Three patients experienced severe hemobilia. CONCLUSION: US- guided left-sided biliary drainage is a highly successful and safe method when the left hepatic duct branch diameter is greater than 3 mm.


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J. E. Lopera, J. A. Soto, and F. Munera
Malignant Hilar and Perihilar Biliary Obstruction: Use of MR Cholangiography to Define the Extent of Biliary Ductal Involvement and Plan Percutaneous Interventions
Radiology, July 1, 2001; 220(1): 90 - 96.
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